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Venlafaxine

This story actually starts at the beginning of July, about a week after we moved to Baltimore. I applied for Medicaid through the healthcare marketplace, as did my fella. Since we listed each other on our applications (not knowing any better) and he filed after me, his app bumped mine out. I was never informed (oops), so I sat around for over a month wondering why I couldn’t get coverage and going through the frustration of weekly phone calls to check on my application, to no avail.

So that brings us to this week, when I finally ran out of my carefully-rationed venlafaxine. I’m supposed to take 75 mg a day, and had been taking 32.5 every other day to make sure I could stretch it because I had no other options. I took my last dose on Monday, and it took about a day and a half for the symptoms to start up. And man, did they come back with a vengeance.

I had two nearly-sleepless nights because of the brain zaps and headaches. My application had been received, Medicaid promised on Tuesday, but I had to give them more time to get me an ID number. Meanwhile, the depressive symptoms, combined with the stress of the whole unfortunate situation, snowballed into something truly awful.

The little sleep I did get this week was plagued by night terrors, involuntary twitching, and (so I’ve been told) a lot of whimpering in my sleep, some of which woke me up. I finally got my scripts filled today, after a bit of a fight regarding the dates on the prescriptions, then came home and promptly collapsed after taking one of my newly-procured venlafaxine.

Moral of the story: Withdrawal is exhausting. It’s hard on the patient, and it’s hard on the patient’s loved ones. Fortunately, my brain immediately grabbed that medication and held onto it ferociously, and I woke up feeling much better (perhaps because I slept like the dead for two hours).

This week was a test of my will to fight and my mindfulness skills. I didn’t cope as well as I had hoped–little things sent me into tears, and I was generally irritable the entire time. I didn’t like being around myself. I was plagued by guilt. I felt, for the first time in years, trapped in my body and helpless to fight my invisible tormentor–the bipolar disorder that had, once again, taken hold despite my best efforts to fix the situation.

The good news is that I’m on the mend. I now have insurance, so I can start shopping for a good psychiatrist/therapist/every other kind of doctor I have to see because my body’s kind of a wreck and I have a bunch of chronic illnesses that tend to require a lot of maintenance.

Have any of you had to detox against your will? I hope not, but from what I’ve been reading, it’s frighteningly common. Stay safe, readers. Hang in there–it’s finally the weekend, and I hope all have a lovely one. 🙂

I’m considering “breaking up” with my current psychiatrist, and it’s a tougher decision to make than I’d anticipated.

I like her as a person, but I feel as though we’re not meshing that well on the doctor-patient front. My depression has been particularly difficult to get a handle on, and treatments that previously worked (like Cymbalta) have suddenly stopped helping for no apparent reason. Yesterday, I called and left a message for her with my third request for an increase in my Effexor dose.

The first time, I was told to be patient and give it more time. When I met with her the week after I went to the ER for my panic attack and pleaded my case (since missing a dose and having a dose that was probably too low to begin with kicked off that whole mess), she added risperidone and told me she didn’t want to increase the Effexor until we’d given the other drug a chance to work.

It’s been a few weeks and the only thing the antipsychotic has done is make me even more drowsy than usual–I’m like the goddamn Dormouse to begin with, and the only change is that now I’m really sleepy on top of being really depressed. And in my desperation, I’ve found myself turning to some pretty unhealthy methods of coping with the low-mood-negative-thoughts-constantly-wanting-to-cry thing.

I called the office again today to see if my message had gotten through; after I gave the doctor filling in a quick (probably 30 second) summary of what’s been going on, she agreed to call in a small increase to see if it helps. It might not; I might need to try another drug. But at least I felt like my concerns were being heard.

I feel like my regular doctor and I have had this disconnect for a while now, and I plan to address it at our next appointment. She’s not a bad doctor by any stretch of the imagination, though there’s a pretty clear class divide between us (she suggested Weight Watchers, which is too expensive to even contemplate, when I expressed concern/anxiety over my weight, and has recommended name-brand drugs and alternative medicine that I can’t afford multiple times, despite me repeatedly telling her that our budget’s tight as it is–therapy is expensive) and I think that’s causing some issues.

I tend to avoid conflict at all costs, so it’s going to be tough for me to broach the subject. But I feel like she really knows her stuff, so I don’t want to just “dump” her. I want to make sure we’re on the same wavelength and see if things improve from there first. On the other hand, I’ve been stuck with doctors who aren’t willing to listen to my concerns and give me what I need, and I don’t want to fall into that trap again (ask me about the thyroid debacle that went down last year).

Are you avoidant? Have you ever had to break up with a doctor? Tell me about it in the comments!